Summary of Chapter 3 of the Introduction to Health Psychology Book (Morrison & Bennet, 4th Edition)

This is the Chapter 3 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands. 

Ch. 3: Health-risk behaviour

Health behaviour:

  • Health behaviour Kasl and Cobb (1966a): They defined it as any activity undertaken by a person believing themselves to be healthy for purposes of preventing disease or detecting it at an asymptomatic stage
  • Health behaviour Harries and Guten (1979): They used the same definition but includex behaviour of “unhealthy” people
    • Crucial assumption --> behaviour motivated with the goal of health
  • Health behaviour Matarazzo (1984):
    • Behavioural pathogen: damaging to health
    • Behavioural immunogen: health-protective
  • Almeda seven: behaviours reduce the development disease and mortality. Increases awareness of behaviours and diseases.
    • Women performed 6 out of 7, lived 7/11 more years
  1. Sleeping (7 to 8 hours)
  2. Not smoking
  3. Alcohol (no more than 1 to 2 per day)
  4. Exercise (regular basis)
  5. Not eating between meals
  6. Breakfast
  7. Weight (no more than 10% overweight)

Heath-risk behaviour:

  • 8 risk factors account for 61% of cardiovascular deaths:
  1. Alcohol
  2. Tobacco
  3. High blood pressure
  4. High BMI
  5. High cholesterol
  6. High blood glucose
  7. Low fruit and vegetable intake
  8. Physical inactivity
  • Behaviours associated with mortality:

    • Heart disease: tobacco/high-cholesterol diet/lack of exercise
    • Cancer: tobacco/alcohol/diet/sexual behaviour
    • Stroke: tobacco/high-cholesterol/alcohol
    • Pneumonia: tobacco/vaccination
    • HIV: unsafe sexual intercourse
  • Disability-adjusted life years: years lost due to ill health/disability/early health --> it's a combination of mortality and morbidity

Smoking/drinking/drug use:

  • Morbidity: cost associated with an illness, such as disability or injury
  • Age-specific mortality: deaths per 100,000, per annum, certain age groups --> (example) compare formal smokers with current smokers

Smoking:

  • Worldwide, 9% of deaths
  • Interventions are effective when combining age-relevant risk information and support

Alcohol:

  • Social use of alcohol is widespread
  • Recommended levels of drinking:
    • Women: no more than 2 drinks per day on average
    • Men: not more 3 drinks per day on average
    • Not exceed 4 drinks on one occasion
    • Don’t drink in specific situations (pregnant/driving/...)
    • Abstain drinking at least once a week

Condom use:

  • Prior to HIV, sexual behaviour was under-researched
  • Condom use begins to decline after 6 months within any given relationship
  • Barriers to safe sex:
    • Alcohol --> tendency towards general risk-taking behaviours
    • Social desirability bias: tendency to answer questions about oneself/one’s behaviour in a way that meets social (or interviewer) approval
    • Women:
      • They expect male objection to condom use
      • Difficulty/embarrassment of raising this issue with a partner
      • Worry suggesting they or the partner has STDs
      • Lack of self-efficacy of condom use
  • Interventions: target health beliefs, but also interpersonal/communication/negotiating skills

Unhealthy diet:

  • Cancer deaths: 30% attributed to smoking cigarettes/ 35% poor diet (high-fat foods/high levels salt/low levels fibre)

Fat intake:

  • Excessive fat intake --> CHD/heart attack
  • Cholesterol: (fat) present in our own bodily cells
    • Serum cholesterol: Normal circulating cholesterol --> is synthesised to produce steroid hormones and it's involved in the production of bile (necessary for digestion) --> it's increased by fatty diet and by age.
    • Fatty foods cholesterol: fat-like substance, contains lipoproteins that very in density:
      • Low-density lipoproteins (LDLs): can lead formation plaques in arteries (bad cholesterol)
      • High-density lipoproteins (HDLs): increase the processing and removal of LDLs by the liver (good cholesterol)
  • Ratio of total cholesterol: HDL + LDL + 20% of even lower density triglycerides --> desirable ratio = 4.5:1
  • Coronary Artery disease (CAD):
    • Atherosclerosis: if a fat molecule (good store of energy) is not metabolised during exercise --> plaques are laid down on artery walls, which thickens and restricts blood circulation to the heart
    • Arteriosclerosis: increased blood pressure causes artery walls to lose elasticity and to harden --> affecting on the ability of the cardiovascular system to adapt to increased blood flow
  • Governmental policy documents “healthy eating/dietary targets”:
    • Maximum of a 30% of food energy (calories) derived from fat intake, from which maximum of 11 % can come from saturated fats

Salt:

  • High blood pressure

    • Normotensive: normal blood pressure
    • Hypertensive: high blood pressure
    • Systolic blood pressure: maximum blood pressure on artery walls --> occurring left vertical output/contraction (measured in relation to diastolic blood pressure)
      • Diastolic blood pressure: minimum pressure of blood wall arteries between heartbeats
  • Effects persist even when performing physical activity, and obesity and other health behaviours are controlled --> need to monitor salt intake from early childhood

Obesity:

  • Body mass Index (BMI): weight (kg) divided squared height (m)

    • Normal weight: BMI between 20-24.9
    • Mildly obese: BMI between 25-29.9 (Grade 1)
    • Moderate/clinically obese: BMI between 30-39.9 (Grade 2)
    • Severely obese: BMI between 40-greater (Grade 3)

Consequences:

  • Underweight --> largest global cause of mortality
  • Obesity:
    • Hypertension
    • Heart disease
    • Type 2 diabetes
    • Osteoarthritis
    • Respiratory problems
    • Lower back pain
    • Some forms of cancer
    • Psychological ill health --> low self-esteem/isolation (from experience of stigmatising behaviour)

Prevalence:

  • 1999 --> 31% of EU adult population is overweight
  • Social learning theory: influence significant others’ behaviour
  • Theories of associative learning: food choice associated with receiving intrinsic and extrinsic rewards or reinforcers --> (examples) pleasure eating with family or stress reduction from “comfort eating”

Causes:

  • Obesity: energy intake that grossly exceeds energy output
  • Genetics:
    • Greater number of fat cells
    • Low metabolic rates
    • Deficiencies hormone responsible appetite regulation and control
      • Leptin: produced by fatty (adipose) tissue. It signals the hypothalamus of the CNS that helps regulate weight --> leptin injection does not consistently reduce the eating behaviour
  • Agonist: simulates effects of neurotransmitters --> it reduces hunger
    • Insufficient to cure overweight, since obesity is attributed to the interaction of physiological and environmental factors

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